Background: Modified Broström-Gould (MBG) surgery is frequently used for chronic lateral ankle instability (CLAI). However, conventional postoperative management (CPOM) due to prolonged immobilization may have adverse effects on tendons, ligaments, and joints, causing stiffness. This prospective, randomized controlled trial aimed to determine outcomes among patients randomized to receive CPOM plus ultrasonography-guided triple injections of leukocyte-rich platelet-rich plasma (LR-PRP) compared to patients who receive only CPOM after MBG surgery. Methods: The present study included 40 patients with symptomatic CLAI who were candidates for the MBG surgery. The patients were randomized into 2 groups of 20, the control and PRP groups. In the PRP group, patients were injected with 3 doses of LR-PRP solution using ultrasonographic guidance. In the first injection, 2 mL of LR-PRP was injected near the injury site, and in the second and third injections, 4 mL of LR-PRP was injected in the tibiotalar joint. All patients received a short leg splint for 2 weeks, followed by 4 weeks in a walking boot. The primary outcome measure was the visual analog scale (VAS), and the secondary outcome measures were the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale and ankle total range of motion (total ROM). The assessment was performed at baseline and 3 and 6 months after surgery. Results: The mean VAS and AOFAS scores improved significantly in both groups 6 months after surgery ( P < .001). However, the PRP group did not significantly improve in VAS or AOFAS scores compared with the control group. No clinically significant difference was observed between the 2 groups regarding the total ROM scores at month 3. Conclusion: The application of LR-PRP after MBG surgery did not show any superior clinical or functional improvement over CPOM. Level of Evidence: Level II, prospective randomized trial.

Various surgical techniques are available for the alleviation of symptoms in carpal tunnel syndrome and each of them has its pros and cons. This study was designed and performed to present a novel approach for cutting transverse carpal ligament by the thread looping technique without the use of ultrasonography. The novel modification of looped threaded carpal tunnel release was performed on 10 hands of 10 patients. The disabilities of arm, shoulder, and hand score, visual analog scale, and 2-point discrimination were used for assessing the outcomes. No patients developed pillar pain or scar discomfort after surgery. Complete elimination of paresthesia, pain, and numbness occurred in all patients. There was a significant reduction in the disabilities of arm, shoulder, and hand and visual analog scale scores (P value<0.05). This technique is safe, available, and effective for carpal tunnel release and minimizes postoperative complications, such as pillar pain, and scar discomfort with avoiding unnecessary injuries to the surrounding soft tissue.

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Background: Trauma is a leading cause of death and morbidity in developing countries. Previous research has revealed that epidemiological features of fractures may change from one study to the next. National Trauma Registry of Iran (NTRI) was launched in 2015, but it did not include any centers in northern Tehran, Iran. This study aimed to evaluate the epidemiology of fractures in the only Level 1 Trauma Center in that area. Methods: This retrospective cross-sectional study was performed on all patients with the primary diagnosis of orthopedic injury, from July to October 2019, who referred to the emergency department of Shohada Tajrish Hospital, Tehran. The patients’ files and operation notes were reviewed for demographics, medical history, physical examination, referral time, mechanism of injury, hospital stay, level of education, and intensive care unit (ICU) hospitalization. Results: 398 patients with orthopedic trauma were referred to the hospital with a mean age of 40.85 ± 21.03 years. 317 patients (79.65%) were men. The peak referral time was between 12 AM and 12 PM. A road traffic accident was the main cause of orthopedic trauma (39.4%). The mean days of hospital stay were 6.29 ± 5.36 days. The waiting time for surgery and days of hospital stay were related to the fracture site (high in lower extremity fractures) and older age. Conclusion: Trauma in northern Tehran is primarily caused by motor vehicle accidents and falls, respectively. Patients with older age and lower extremity fractures need more time of hospitalization.